Organization Active NPI

Paterson Division of Health

  • Public Health or Welfare Agency
  • Paterson, NJ
National Provider Identifier
1801001300
Registry record updated Mar 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
PATERSON DIVISION OF HEALTH
Practice address
176 Broadway
Paterson, NJ 07505-1115
Phone
(973) 321-1277
Fax
(973) 278-4916
NPI assigned
May 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Irene R Edwards, BSN
Title
Head Nurse
Phone
(973) 321-1277

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X NJ Primary

Addresses

Primary practice location

176 Broadway
Paterson, NJ 07505-1115

Mailing address

176 Broadway
Paterson, NJ 07505-1115
Phone (973) 321-1277

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140319000329 NJ Part B Supplier - Mass Immunization (Roster Biller Only) 0446280663 Practice locations: Paterson, NJ
O20150303000578 NJ Part B Supplier - Clinic/Group Practice 0446280663 Receives reassigned benefits from 2 practitioners
Practice locations: Paterson, NJ

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Paterson Dept of HLTH P2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

850 Madison Ave
Paterson, NJ 07501
Phone (973) 321-1350

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299024000000",
    "number": "1801001300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 BROADWAY",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075051115",
            "telephone_number": "973-321-1277",
            "fax_number": "973-278-4916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 BROADWAY",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075051115",
            "telephone_number": "973-321-1277",
            "fax_number": "973-278-4916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATERSON DIVISION OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2011-03-02",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "IRENE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "HEAD NURSE",
        "authorized_official_telephone_number": "973-321-1277",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BSN"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.